A chronic condition is defined as a condition that lasts 12 months or longer and meets one or both of the following tests: (a) it places limitations on self-care, independent living, and social interactions; (b) it results in the need for ongoing intervention with medical products, services, and special equipment. AHRQ has research, tools and resources to help clinicians assist their patients who have chronic conditions.
The Office of Enterprise Data and Analytics, within the Centers for Medicare & Medicaid Services (CMS), has developed a set of information products and analytics examining chronic conditions among Medicare fee-for-service beneficiaries. OEDA produces this information to provide researchers and policymakers a better understanding of the burden of chronic conditions among beneficiaries and the implications for our health care system. Information on prevalence, utilization, and Medicare spending for specific chronic conditions and multiple chronic conditions demonstrates the overall burden and complexity of chronic conditions among Medicare beneficiaries and can be used to identify high risk Medicare beneficiaries, as well as inform policy makers and providers about resource utilization of patients with chronic diseases.
Several resources are available to researchers, policymakers, and other users who are interested in learning more about chronic conditions among Medicare beneficiaries, including tabular geographic data reports (data years 2007-2018) as well as interactive dashboards and atlas (data year 2018).
Note: On October 1, 2015 the conversion from the 9th version of the International Classification of Diseases (ICD-9-CM) to version 10 (ICD-10-CM) occurred. Regardless of when a claim was submitted for payment, services that occurred prior to October 1, 2015, use ICD-9 codes. Chronic conditions identified in 2015 are based upon ICD-9 codes for the first ¾ of the year (January-September) 2015 and ICD-10 codes for the last quarter of the year (October-December). Starting in 2016, chronic conditions identified are based upon ICD-10 codes for the full year.
